Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.01 / $174.77 / $190.94	Facility	26	$75.01	$174.77	$190.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.08 / $151.59 / $173.62	Professional		$130.08	$151.59	$173.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.70 / $75.01 / $78.73	Professional	26	$72.70	$75.01	$78.73
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $55.03 / $77.72 / $94.88	Professional	TC	$55.03	$77.72	$94.88
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $155.32 / $172.58 / $284.76	Professional		$155.32	$172.58	$284.76
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $78.01 / $86.68 / $94.48	Professional	26	$78.01	$86.68	$94.48
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $77.31 / $85.90 / $93.63	Professional	TC	$77.31	$85.90	$93.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $143.94 / $419.95 / $669.01	Professional		$143.94	$419.95	$669.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.08 / $196.88 / $338.10	Professional	26	$85.08	$196.88	$338.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.53 / $225.39 / $330.91	Professional	TC	$49.53	$225.39	$330.91
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $162.78 / $371.33 / $371.33	Professional		$162.78	$371.33	$371.33
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $80.38 / $177.78 / $177.78	Professional	26	$80.38	$177.78	$177.78
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $82.41 / $193.55 / $193.55	Professional	TC	$82.41	$193.55	$193.55
United Facility/Professional Professional Modifier Low / Median / High Price $105.57 / $401.76 / $486.37	Professional		$105.57	$401.76	$486.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.07 / $122.03 / $225.13	Professional	26	$61.07	$122.03	$225.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.52 / $128.87 / $262.17	Professional	TC	$35.52	$128.87	$262.17